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General NPI Number Information
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NPI Number | 1578261954
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Entity Type | Individual
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Provider Name | ANKITA BHALLA
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Gender | Female
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Dates
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Enumeration Date | 02/16/2023
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 103B W US HIGHWAY 80
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City | WHITE OAK
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State | TX
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Zip | 75693-2003
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Country | US
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Telephone | 430-201-2511
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Fax |
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Provider Business Mailing Address
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Address Line | 5700 TAPADERA TRACE LN APT 411
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City | AUSTIN
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State | TX
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Zip | 78727-6306
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Country | US
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Telephone | 515-661-1551
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 37205
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 37205
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License Number State | TX
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